尽管无需专门或侵入性技术即可检测到黑色素瘤，但其仍是癌症死亡的重要原因。了解预防性行为（如皮肤自我检查）的障碍可以帮助确定增加早期发现频率的干预措施。为了确定美国三个高发病率州黑色素瘤知识和信念的情况，我们向代表性样本发送了15,000份调查问卷。我们的目标是评估（1）黑色素瘤识字能力（即对黑色素瘤风险、态度和预防行为的知识）和（2）自我报告的皮肤自我检查及其与黑色素瘤识字能力、自我效能和信任皮肤自我检查的好处的关联。在2326名受访者中，只有21.2％的回答表明对黑色素瘤有较高的了解，并有62.8％的人报告曾经在生活中进行过一次或多次皮肤自我检查。只有38.3％和7.3％的人报告对进行皮肤自我检查表示“相当”或“非常”自信。受访者中的皮肤自我检查执行率与较高的黑色素瘤知识、较高的自我效能和个人黑色素瘤病史相关性最强。调查受访者的黑色素瘤识字能力较低，知识水平越高，报告的预防行为的可能性越大。此评估为制定旨在增加对这种致命癌症的预防和早期发现的公共卫生宣传活动提供了基准和指导。© 2023 The Authors. Pigment Cell & Melanoma Research published by John Wiley & Sons Ltd.

Melanoma is a significant cause of cancer death, despite being detectable without specialized or invasive technologies. Understanding barriers to preventive behaviors such as skin self-examination (SSE) could help to define interventions for increasing the frequency of early detection. To determine melanoma knowledge and beliefs across three high-incidence US states, 15,000 surveys were sent to a population-representative sample. We aimed to assess (1) melanoma literacy (i.e., knowledge about melanoma risks, attitudes, and preventive behaviors) and (2) self-reported SSE and its association with melanoma literacy, self-efficacy, and belief in the benefits of SSE. Of 2326 respondents, only 21.2% provided responses indicating high knowledge of melanoma, and 62.8% reported performing an SSE at any time in their lives. Only 38.3% and 7.3% reported being "fairly" or "very" confident about doing SSE, respectively. SSE performance among respondents was most strongly associated with higher melanoma knowledge, higher self-efficacy, and personal history of melanoma. Melanoma literacy among survey respondents was modest, with greater literacy associated with a higher likelihood of reported preventive behavior. This assessment establishes a baseline and provides guidance for public health campaigns designed to increase prevention and early detection of this lethal cancer.© 2023 The Authors. Pigment Cell & Melanoma Research published by John Wiley & Sons Ltd.